S588 A Comparison of Using an Adult vs. Slim Colonoscope in Performing Routine Colonoscopy in Adult Patients: A Systematic Review and Meta-Analysis

Abstract

Introduction: Colonoscopy is one of the most commonly performed procedures in adult patients in The United States. Colonoscopy remains the gold standard for colorectal cancer screening given the ability for direct visualization of the colonic mucosa. Adult colonoscopy is generally performed using either an adult colonoscope (AC) or a thinner diameter slim colonoscope (SC). The purpose of this systematic review and meta-analysis was to compare these instruments when performing routine colonoscopy in adult patients. Methods: We conducted a comprehensive search of several databases from inception to March 2021, which included Ovid Cochrane Database of Systematic Reviews, Ovid Embase, Scopus, Ovid Cochrane Central Register of Controlled trials, Ovid MEDLINE®, and In-Process and other non-indexed citations. The outcomes assessed were cecal intubation rate (CIR), terminal ileum intubation rate (TIIR), and insertion time (IT). Results: The results are summarized in table 1. Eight studies were included for final analysis. There were 2,819 total patients (1403 AC, 1416 SC). For CIR, the pooled results favored SC over AC (0.54). For TIIR, there was no difference (0.99). Similarly, for IT there was no difference (OR -0.14). Conclusion: In this systematic review and meta-analysis, for adult colonoscopy the CIR was superior using SC as opposed to AC. There was no difference in TIIR or IT.Table 1.: Outcomes